Cerebral Cavernoma

What Is A Cavernoma? What Does It Look Like?

A cavernoma or cavernous malformation is a rare condition involving the abnormal dilation of a group of blood vessels. As a result of this dilation, bubble-like cavities called caverns form in the affected blood vessels. The flow of blood through these caverns is slowed down and the walls of the vessels are particularly weak at these spots. Hence, there is a possibility of the walls being breached and giving rise to bleeding. Since these dilated blood vessels with caverns appear in clusters and tend to be red (or purplish) in color, they are often likened to raspberries in appearance. Technically, a cavernoma is considered a type of vascular lesion.

What Is A Cerebral Cavernoma?

Cavernomas can arise anywhere in the body. They may even be present in the skin, where they are clearly visible externally, forming red bumps. Those that affect the central nervous system (the brain or spinal cord or both) are rather rarer. Generally, spinal cord cavernomas are rarer than those in the brain. A cerebral cavernoma could potentially develop in any part of the brain and in an individual of any age, gender or ancestry.

Sometimes, a single individual could have multiple such abnormal formations in the brain. These may be so small as to only be noticeable under a microscope. Others may span several inches in diameter. These dilated blood vessels could leak out the blood that has pooled within them. They could even give rise to various neurological symptoms that could be life-threatening.

What Causes Cerebral Cavernomas?

The true cause is not well understood. A small number of cases are attributed to genetic factors as the condition appears to run in certain families. There are two main scenarios associated with the formation of cavernous malformations in the brain, namely:

• A hereditary condition is known as familial multiple cavernous malformation syndromes.
• Having received radiation to the head and neck region. This includes radiation therapy or accidental exposure.

What Are The Symptoms Of A Cerebral Cavernoma?

When a cavernoma arises in the central nervous system, it is capable of causing severe neurological symptoms and potentially fatal complications. The nature and severity of symptoms are dependent on the specific location of the cavernoma in the brain or spinal cord. Sometimes, though, the condition is ‘silent’ and does not cause any noticeable symptoms.

Some potential symptoms are listed below:

• Headaches.
• Dizziness.
• Slurring of speech.
• Numbness.
• Other sensory disturbances.
• Weakness.
• Double vision or blurring of vision.
• Difficulty maintaining balance.
• Difficulty with memory.
• Internal bleeding.
• Tremors.
• Seizures.
• Hemorrhagic stroke.

Ensure that your surging blood pressure doesn’t trigger a cerebral cavernoma.

Do Cerebral Cavernomas Cause Any Complications?

Symptoms often set in when a cerebral cavernoma bleeds. But they tend to abate as the blood is reabsorbed. This can happen when bleeding is very gradual or when a very small quantity of blood leaks from the cavernoma. Symptoms can worsen progressively if there is a significant and continuous bleed. A bleeding cavernoma can progressively build up pressure on the nervous tissue around it and this can have critical outcomes. For one, it could cause a significant hemorrhage. The risk of hemorrhage is compounded if the patient is found to have multiple such malformations. However, superficial lesions are less likely to bleed than more deep-seated ones.

How Can This Condition Be Diagnosed?

Based upon the symptoms alone, it is difficult to accurately diagnose a case of brain or spinal cavernoma. This is especially true since the condition is quite a rare one. Cavernomas are sometimes detected incidentally while conducting tests investigating some other neurological problem. The best way to correctly identify this condition is by means of magnetic resonance imaging (MRI) tests.

In general, the standard diagnostic protocol would include the following steps:

• Physical examination.
• Medical history.
• Computerised tomography (CT) tests.
• Angiogram.
• Magnetic resonance imaging (MRI) test.

Treatment and Prevention

Once the lesion or lesions have been detected, the doctor may or may not advise making any active intervention. If the lesion is largely asymptomatic and small in size, it may be advisable to leave it as it is. In order to keep an eye on the cavernoma, it would still be necessary to monitor it by repeating the tests at regular intervals. On the other hand, some cases may require therapy and there are a number of options available. Medications can help to manage seizures and prevent strokes. Surgery is another alternative. However, the choice of treatment will depend on the extent and severity of the condition and the specific location of the lesion. It is also important to take into account the general health and age of the patient before proceeding to undertake surgery.

There are no methods to prevent cerebral cavernoma. However, adopting a healthy lifestyle, management of weight, cholesterol levels, and blood pressure levels is advised. Stress levels should be checked in order to prevent the sudden shooting up of blood pressure.

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